I have blocked nose and IgE 770. How should I manage it?

Question

Hello doctor,

I am reaching out because I have been dealing with several health issues that I would like help with.

Nasal blockage: One side of my nose is always blocked. It switches between nostrils every few hours. When I run or exercise, both nostrils open up.
Allergy: I recently got tested, and my IgE level is 770, which I was told is very high.
Mucus and breathing issues: I often have thick nasal mucus and coughing with mucus. When I visit my village, I experience breathing difficulty and chest tightness.
Relief with Duolin respules: I use a nebulizer with Duolin respules, and it helps me breathe better.

My goal is to become a captain, so I need to be in excellent health. I want to know what tests I should take, what treatment I need, and how I can recover fully. Please guide me step by step. I am ready to follow your advice seriously.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I hear your goal and your urgency. The pattern you describe fits: allergic rhinitis with likely asthma or airway hyper-reactivity. The alternating blocked nostrils are a normal nasal cycle; in allergy, it feels exaggerated. And your symptoms point to bronchospasm on an allergic background.

An IgE of 770 confirms a strong allergy, but remember, total IgE is nonspecific; what matters is control of symptoms and the specific triggers.

First, let us confirm the diagnosis and your current baseline. Get spirometry with bronchodilator reversibility, FeNO (fractional exhaled nitric oxide) if available, and a CBC (complete blood count) with absolute eosinophil count.

Add a chest X-ray PA (posterio-anterior) view and an allergen panel. If nasal blockage and discharge persist for more than 12 weeks, see an ENT (ear-nose-throat) doctor for a nasal checkup if the issue persists even after nasal medications I prescribe. Because total IgE is high, also do a simple stool exam for parasites (and treat if positive), and check vitamin D.

And after you get your chest checked with a stethoscope and your spirometry confirms an asthma component, you should use MDI (metered dose inhaler) Budesonide–formoterol 400/6: two puffs twice daily with a spacer for eight to 12 weeks, and one puff as needed for symptoms or 10 to 15 minutes before hard exercise. This treats the inflammation and the spasm together and is the preferred modern plan. Keep Duolin as backup only if you have a bad flare.

Treat the nose daily; it is driving a lot of the cough. Start an intranasal spray (Fluticasone plus Azelastine) two sprays per nostril once daily after a saline rinse, then sniff gently, not hard. Add Montelukast plus Levocetirizine in the evening for ten days, and then Montelukast 10 mg at bedtime for a month and reassess. For thick mucus, you may use N-acetylcysteine 600 mg twice daily for seven to 10 days and plenty of warm fluids.

Control the environment that provokes you in the village. Minimize exposure to dust, smoke, incense, biomass or stubble burning, and animal sheds. Avoid cigarette smoke completely.

Build fitness safely for your captain's goal. Do a 10 to 15 minute warm-up, then progress cardio 10 percent per week as symptoms allow. With good control, your peak flow should be stable, and you should complete a six-minute walk or a 20 to 30-minute run without rescue puffs.

You can expect clear improvement in two to three weeks and excellent control in six to eight weeks if you follow this plan precisely. I am with you step by step. Once your spirometry and allergy results are in, we will fine-tune doses and help you clear the medical fitness requirements confidently.

I hope this information will help you.

Kindly follow up if you have more concerns.

Thank you.